27 posts from April 2009

April 30, 2009

The Food and Drug Administration moved today to strengthen safety alerts for Botox, a product that has smoothed brows across America.

For the first time, the federal agency will require manufacturers of botulinum toxin products—including Botox—to include a black box on drug labels warning of potentially serious side effects. Black box warnings are the FDA's most stringent safety alert.

Also, the FDA will require that patients receive a medication guide informing them about potential risks when they come to doctors’ offices for injections.

The agency’s action follows its approval Wednesday of Dysport, a new botulinum toxin product now licensed for sale in the U.S. Other licensed products are Botox and Myobloc.

In February 2008, the FDA first alerted the public about potential problems associated with products containing botulinum toxin, an agent that paralyzes muscles and that can make wrinkles or excessive underarm perspiration disappear.

Specifically, when significant doses of these products are administered, the toxin can travel from the injection site to other parts of the body, causing muscle weakness, double vision, loss of bladder control, and trouble speaking, breathing and swallowing, according to Dr. Ellis Unger, an acting deputy director at the FDA’s Center for Drug Evaluation and Research.

People are hungry for information about the swine flu and what to do if a family member takes ill with flu-like symptoms.

In researching the topic, I’ve come across a good resource from the Centers for Disease Control and Prevention, titled Interim Guidance for Swine Influenza A (H1N1): Taking Care of a Sick Person in Your Home. (For a copy, click here.)

Several nuggets of information in the document deserve widespread dissemination. Here are some of the most important, in a question and answer format:

Q. How long should I stay home if I have swine flu?

A. The CDC says “stay home for seven days after the start of illness” symptoms.

Q. What medications should I give my child with flu symptoms?

A. Don’t give aspirin to children or teenagers who have the flu. The CDC notes “this can cause a rare but serious illness called Reye’s syndrome.” Double-check labels for all cold and flu medications to make sure they don’t contain aspirin.

Don’t give a child younger than 2 an over-the-counter cold medication without speaking first to a doctor or nurse. Safest for children in this age group is “using a cool-mist humidifier and a suction bulb to help clear away mucus” from the nose, the CDC says.

April 29, 2009

Swine flu has surfaced in Illinois, and people are bound to have many questions as the illness arrives a step closer to home.

I asked Dr. Mark Dworkin, an associate professor of epidemiology at the University of Illinois Chicago School of Public Health, to discuss some common queries. Dworkin is the author of a timely new book, “Outbreak Investigations Around the World."

An edited version of our conversation follows:

Q. What symptoms are associated with swine flu?

A. The classic symptoms are the same as with any flu: muscle aches, a fever (typically 101 or higher) and a dry cough. Other symptoms may include nausea, vomiting, a sore throat, a runny nose, and diarrhea. These symptoms tend to have an abrupt onset. Suddenly, you’ll notice that you’re feeling very bad. But this isn’t true for everyone. If you’ve been exposed to a similar virus strain in the past or you’ve been vaccinated against the flu, you may feel only mildly ill.

Q. What should I do if I or a family member have these symptoms?

A. The first thing you want to consider is whether you’ve been near someone who may have swine flu. If you think you have been exposed, get in touch with your doctor.

April 23, 2009

It’s a sad day for Pilsen and the University of Illinois at Chicago Medical Center.

The community and the university are both losers as UIC prepares to close a small health clinic in the neighborhood.

UIC started the clinic five years ago to provide prenatal care and primary care to a largely Spanish-speaking low-income population. It’s been a big success, making people feel at home and drawing up to 5,000 patients a year.

But the finances of the center have been dismal. Most patients are covered by the state’s Medicaid program for poor families, which is notorious for its stingy payments.

Unable to make ends meet, the clinic has been losing $200,000 a year -- or $1 million over the time it’s been open, said Dr. Sarah Kilpatrick, head of obstetrics and gynecology at UIC.

Given the current economic climate, the medical center decided to close the Pilsen clinic about a month ago. It reconsidered when there was a loud outcry from students, staff and the community. But after reviewing the decision, administrators decided they had no other option, Kilpatrick said.

Today, more than 100 medical students and staff and Pilsen residents gathered at the UIC Medical Center to protest the decision and ask that it be reversed. The university has more than enough money to keep the clinic afloat if it wants to, said Yalda Afshar, a student in UIC’s joint MD/PhD program.

April 22, 2009

Why are so many women having repeat Cesarean sections and why are vaginal births after C-sections declining so precipitously?

I put the question to Dr. Carolyn Zelop, director of maternal fetal medicine at St. Francis Hospital and Medical Center in Hartford, Conn., after I wrote about the topic last week. She’s a nationally recognized expert.

New government data shows that 90 percent of women who had previous C-sections now get the procedures when they give birth again, a 40 percent rise from a decade ago.

Zelop explained that when vaginal births after C-sections peaked in 1996, small research studies had suggested they were safe. But since then, larger studies have demonstrated a potentially catastrophic complication associated with these births – uterine rupture.

"What is the definition of "dependent"? If the individual is no long claimed as a dependent on parents' income taxes, can they be considered a dependent for the purposes of this program?"

This question from a reader followed my recent post about a new Illinois law that allows parents to keep their children on their health insurance policies until the age of 26. The new law goes into effect June 1. To read my original post, click here.

I asked the Illinois Division of Insurance to help me answer this reader's question. Their response, printed below, makes it clear that a young adult does not have to be claimed on parents' income tax or in school to be considered a dependent.

Some insurance policies may, however, require that the young adult live with his or her parents for a certain period of time each year to be considered a dependent eligible for insurance coverage.

A response from the Illinois Division of Insurance:

What counts as a dependent under the new law allowing parents to extend coverage to young adults up to age 26?

The new dependent coverage law (Public Act No. 95-0958) prohibits companies from declining coverage for dependents due to age (up to age 26 or 30 for military veterans), health, or enrollment in an educational institution. The law does not otherwise restrict the definition of dependent. However, companies may not impose an eligibility requirement that serves as a proxy for age, such as the IRS dependency rules discussed below.

April 21, 2009

Illinois made a bet three years ago that extending medical coverage to children and families would reduce the ranks of the uninsured.

A new report from Chicago’s Gilead Outreach & Referral Center suggests the wager paid off—at least for a while, before the economy began its steep downward descent.

Between 2006, when Illinois launched its All Kids program, and 2007, the last year for which comprehensive data are available, the number of uninsured children in the state dropped by nearly 90,000, or 27 percent.

All Kids offers health insurance to every child in the state, with subsidies available to those at the lower end of the income ladder. It was former Gov. Rod Blagojevich’s signature health care program.

As boys, they lived across the street from each other on the Near North Side. They’ve been buddies ever since. Now, these two older men are engaged in a demanding venture – providing free health care to the uninsured.

George Maltezos, 72, came up with the idea first. “Each of us felt we needed to do something after retirement,” said Maltezos, a former mental health and substance abuse professional. “And we both were fully aware of how many people don’t have health insurance.”

Dr. Charles Martinez, 74, who worked as a nuclear medicine specialist, wasn’t initially inclined to go along. But then, at a medical school reunion, he heard an 87-year-old colleague talk about starting a free clinic and his interest was piqued. Soon, he embraced the project.

The longtime friends wanted to locate the clinic in an area with a significant need for health care services. Market research helped them pick the neighborhood around Addison Street and Pulaski Road.

In the four closest ZIP codes – 60641, 60618, 60639, 60647 – more than 135,000 people were uninsured, according to public data. Also, there were few safety-net health care facilities in the area – clinics and hospitals whose mission it is to serve the poor and the uninsured.

There’s new evidence today that breast-feeding is good for moms well as babies.

It appears in an Obstetrics & Gynecology report concluding that women who breast-feed are less likely to have heart disease, heart attacks and strokes.

Other scientific studies suggest breast-feeding reduces the risk of diabetes as well as breast and ovarian cancer.

The new report examined 139,681 post-menopausal women who’d had at least one child and who completed extensive surveys about their medical, reproductive and family histories.

After controlling for factors such as age, race, education, income, lifestyle and body mass index, researchers found that breast-feeding for more than a year was associated with lower rates of hypertension, diabetes and high cholesterol.

About this blog

Getting the medical care you need isn't easy. Resources can be hard to find. Weighing the costs and benefits of proposed interventions can be difficult. Choosing a doctor or a hospital, negotiating with your insurer, staying on top of treatment trends, getting the best care possible -- all these can be nerve-wracking. This blog will bring you useful information, connect you with important resources and highlight the stories of other people like you.